For a long time, I believed you were either for Health Savings Accounts (HSAs) or you were for Flexible Spending Accounts (FSAs), but you couldn’t be for both. The very nature of HSAs prevented you from also participating in a General Medical FSA . Over time, I came to realize that HSAs and FSAs each had their place, if only you could understand when each made sense. So here is a quick reference to understanding when to choose an FSA vs. HSA. To learn more about FSAs and HSAs, download our account comparison chart.